The present invention relates to a guide for assisting medical personnel in inserting an endotracheal tube into the trachea, or windpipe, of a patient.
Endotracheal intubation is the technique of inserting a tube into the trachea of a patient in order to aid in or permit respiration. It is commonly used in surgery and in emergency care situations, for example, in the case of trauma or cardiac arrest victims suffering from breathing difficulties. Various other techniques for securing an airway are known, such as the esophageal obturator airway, the esophageal gastric tube airway, and the pharyngeal tracheal lumen airway, as well as mouth to mouth or bag and mask respiration. However, none of these places an airway into the trachea, and, thus, none of them will truly secure the airway to prevent potential aspiration of blood, vomitus, or other foreign material into the lungs. Additionally, some of these techniques can induce major additional trauma in the patient.
Thus, endotracheal intubation is generally considered to be the superior method of securing an airway and assuring adequate ventilation. However, one problem with this technique is that it requires significant operator skill and experience. Unskilled insertion can cause additional injuries, for example, to the front incisors. Another problem is that many existing techniques for inserting a tube into the trachea require special positioning of the patient's head, and thus cannot be done with trauma victims until cervical spine fractures have been ruled out, because of the possibility of additional spinal cord damage.
A laryngoscope is commonly used to aid in placing of an endotracheal tube. This allows the operator to observe the insertion of the tube, but requires that the patient be positioned with their head tilted back, which is not normally possible with trauma victims. Visualization of the larynx may be impossible if the pharynx is filled with blood or vomitus. Laryngoscopes are relatively difficult instruments to handle, even for skilled medical personnel. Thus, they are not normally suitable for use by paramedical personnel in the field.
Other endotracheal intubation techniques involve the insertion of the tube "blind" or by feel. Some devices have been proposed in the past for aiding in "blind" insertion of an endotracheal tube. U.S. Pat. No. 4,612,927 of Kruger, for example, shows an instrument of open channel section terminating in a head having a central concavity for engaging the rear of the larynx. A tube can then be guided along the channel and directed into the trachea via a suitable ramp adjacent the head of the instrument. U.S. Pat. Nos. 4,054,135, 4,068,658, 4,067,331, and 4,069,820 of Berman all show a pharyngeal airway for intubation which has a distal tip for engaging the epiglottis to direct a tube into the trachea.